cross blue
BCBS of MA begins physician analysis program
Working with an outside information technology vendor, Blue Cross Blue Shield of Massachusetts has begun a program designed to identify patients whose care isn't meeting clinical guidelines. The vendor, MDdatacor, will analyze data from EMRs, transcribed office notes, lab results, and cross-reference that with the plan's pharmacy and claims data. BCBS plans to use the analysis as part of its pay-for-performance program. BCBS will begin by offering the tools to a subset of its physicians, …
... Read more...Boston docs challenge Partners HealthCare
About 300 Boston-area doctors, once part of market-dominating Partners Health System (PHS), began blazing their own trail this week as competitors to their former colleagues. Partners is a giant force in the region, affiliated with 1,000 primary care doctors and 3,500 specialists, and can negotiate some of the best deals with insurance. Now, the doctors have become part of a smaller system including Beverly Hospital, Addison Gilbert Hospital, mental health/substance abuse facilities and …
... Read more...Horizon BCBS settles with MDs
New Jersey's Horizon Blue Cross Blue Shield health plan, which insures 3.2 million consumers, has settled a class action suit claiming its reimbursement practices had treated thousands of doctors unfairly. The suit, which was filed in 2002 on behalf of about 40,000 of the state's physicians, contended that the HMO--along with United Healthcare and Cigna Healthcare--was paying doctors late and reducing payments unfairly. In settling the suit, which doesn't involve a payout by the health …
... Read more...Health plan premium increases slow
According to research by an independent organization, health plans expect to raise premiums 8.2 percent for 2007, down 0.2 percent from 2006. However, when other factors are considered, this should still lead to an 18.2 increase in employee contributions for next year, according to Sherlock Company projections (This should be painful for employees, given that premiums are rising at rates …
... Read more...ALSO NOTED: RI hospital braces for strike; The growing role of alternative medicine; and much more...
> North Dakota's insurance commissioner says that Blue Cross Blue Shield, the state's largest insurer, has plenty of money on reserve to waive member's premiums for one month. He says BCBS doesn't need to increase its rates next year. Report
> A series of reports from Argus Courier examines the high toll that healthcare costs are taking on physicians and their …
... Read more...Editor's Corner
Yesterday, we noted that Blue Cross Blue Shield of Massachusetts was introducing a new product which established tiered co-pays for hospitals and MDs based on price and quality measures. Providers that charge more--or don't seem to perform well--cost consumers more out of pocket …
BCBS rolls out data mining program
Twenty Blue Cross Blue Shield plans around the nation will participate in Blue Health Intelligence, a massive data-mining project that will make information available on a range of health trends and measures. The object of the database is to enable employers, consumers and providers learn what type of healthcare works best based on information gathered from 79 million people. Initially, the HIPAA-compliant data will be available only to employers, but consumers and providers will …
... Read more...BCBS of Ga. and Piedmont finally come to terms
After a stressful seven-month battle that included bitter public statements and a couple of lawsuits, plus a month-long contract gap that left patients scrambling for providers, Piedmont Healthcare and Blue Cross Blue Shield of Georgia have finally come to a new three-year agreement. Specific details are confidential. In a joint press release, both parties magnanimously invite those enrollees who …
... Read more...BCBS dumps Piedmont contract
Late last Friday, thousands of patients were still waiting to hear whether Piedmont Healthcare and Blue Cross Blue Shield of Georgia would settle a contract dispute that's been dragging out for almost six months. The answer came at 12:05 AM Saturday morning when a (conveniently timed) BCBS press release announced that the contract expired and would not be renewed. The expiration will impact 131,000 area members who will now have to pay higher out-of-pocket costs if they want to continue …
... Read more...RelayHealth in Empire deal
Empire Blue Cross Blue Shield of New York and RelayHealth said they will significantly expand a pilot project that allowed members to sign up for online consultations. The service, which will be known as WebVisits, will allow 400,000 members of the health plan to sign up for "virtual visits" via email and the RelayHealth website. The partners recently completed an 18-month pilot of the technology that offered the service to 3,000 patients at Columbia University in New York. Patients will …
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